Cho Hye Hyun, Kwon Kye Chul, Sung Ji Youn, Koo Sun Hoe
Department of Laboratory Medicine, College of Medicine, Chungnam National University, 640, Daesa-dong, Jung-ku, Daejeon 301-721, Korea; phone: +82 42 280 7798, fax: +82 42 257 5365; e mail:
Ann Clin Lab Sci. 2013 Fall;43(4):414-9.
Pseudomonas aeruginosa is one of the primary opportunistic pathogens responsible for nosocomial infections. Recently, sequence type 235 (ST235) has been found internationally in a multidrug-resistant clone and is involved in the dissemination of genes encoding IMP-6 and VIM-2. This study aimed to describe the prevalence of metallo-β-lactamase (MBL), epidemiological relationship, and genetic characterization to aminoglycoside resistance in carbapenem-resistant P. aeruginosa isolates obtained from a tertiary hospital in Daejeon, Korea, from 2008 to 2012. Minimum inhibitory concentrations (MICs) of six antimicrobial agents were determined using the agar dilution method. PCR and DNA sequencing were used to identify MBL genes, class 1 integrons, and genes contributing to the aminoglycoside resistance phenotype. In addition, an epidemiological relationship was investigated by multilocus sequence typing (MLST). Eleven (16.2%) carbapenem-resistant isolates were MBL-producers; the major MBL type was IMP-6 (10 isolates). IMP-6-producing isolates were multidrug-resistant and belonged to ST235. All IMP-6-producing isolates had class 1 integrons (5.5 Kb; blaIMP-6-qac-aacA4-blaOXA-1-addA1). We identified genetic characteristics in aminoglycoside genes between ST235 and non-ST235. All ST235 isolates contained aminoglycoside-modifying enzyme (AME) genes, whereas 23.5% of non-ST235 isolates contained AME genes. Development and spread of the aminoglycoside resistance gene in P. aeruginosa non-ST235 could result in multidrug resistance in the future.
铜绿假单胞菌是引起医院感染的主要机会致病菌之一。最近,国际上发现序列型235(ST235)存在于多重耐药克隆中,并参与编码IMP-6和VIM-2基因的传播。本研究旨在描述2008年至2012年从韩国大田一家三级医院分离出的耐碳青霉烯铜绿假单胞菌中金属β-内酰胺酶(MBL)的流行情况、流行病学关系以及对氨基糖苷类耐药的遗传特征。采用琼脂稀释法测定六种抗菌药物的最低抑菌浓度(MIC)。用聚合酶链反应(PCR)和DNA测序鉴定MBL基因、1类整合子以及导致氨基糖苷类耐药表型的基因。此外,通过多位点序列分型(MLST)研究其流行病学关系。11株(16.2%)耐碳青霉烯分离株产MBL;主要的MBL类型是IMP-6(10株)。产IMP-6的分离株多重耐药且属于ST235。所有产IMP-6的分离株都有1类整合子(5.5 Kb;blaIMP-6-qac-aacA4-blaOXA-1-addA1)。我们确定了ST235和非ST235之间氨基糖苷类基因的遗传特征。所有ST235分离株都含有氨基糖苷类修饰酶(AME)基因,而非ST235分离株中有23.5%含有AME基因。铜绿假单胞菌非ST235中氨基糖苷类耐药基因的产生和传播可能导致未来的多重耐药。